Dimensional analysis of personality in adolescents with suicidal behavior.

OBJECTIVES: This study is aimed at validating the dimensional internalizing and externalizing approach to personality in a sample of adolescents with suicidal behavior and analyzing the psychopathological and syndromic differences between adolescents from each dimension. METHOD: It is a descriptive and cross-sectional study of 75 adolescents (75% women) who attended the emergency service of a pediatric hospital due to suicidal behavior. Sociodemographic, clinical and psychopathological data and personality profiles (MACI) were gathered. RESULTS: The factorial analysis found two factors (total variance of 77.65%): an internalizing (28% of the cases) and an externalizing profile (72% of the cases). Statistically significant differences were obtained between the two profiles in the expressed concerns and the clinical syndromes of the MACI. CONCLUSIONS: Two differentiated personality profiles were found in our sample of adolescents with suicidal behavior. The externalizing profile was more prevalent. These profiles should guide clinical decisions and help plan therapeutic interventions to reduce the risk of suicidal behavior relapse.

Perceived positive and negative consequences after surviving cancer and their relation to quality of life.

Surviving childhood cancer has multiple implications on both physical and psychological domains of the individual. However, its study and possible effects on health-related quality of life (HRQoL) outcomes of adolescent survivors has been understudied. The objective of this study was twofold; to assess positive and negative cancer-related consequences (psychosocial and physical) in a sample of adolescent cancer survivors and to explore their relationship with HRQoL outcomes. Forty-one participants answered two questions about positive and negative consequences in the aftermath of cancer and filled in the KIDSCREEN-52 self-reported version. Data were analysed using mixed methods approach. Overall, 87.8% of the studied sample identified positive consequences and 63.4% negative consequences in survivorship. Four positive categories and five negative categories with regard to cancer-related consequences were found. Changed perspectives in life narratives seem to be the positive consequence more related to HRQoL (physical well-being, mood & emotions, autonomy, social support & peers), followed by useful life experience (physical well-being, autonomy, social support & peers). Psychological impact was the most referred negative consequence with a significant detrimental effect on social support and peers HRQoL dimension. Even if the majority of survivors reported benefit finding in the aftermath of cancer, concomitant positive and negative consequences have been found. However, findings only reveal a significant relationship between positive narratives and HRQoL, and negative consequences do not seem to have a significant influence on overall HRQoL in survivorship.

Predictors of Suicide Behavior Relapse in Pediatric Population.

Identifying patients at increased risk of suicide remains a challenge today. It has been reported that 10% of patients committing a suicide attempt end up dying and that both the risk and the severity of clinical symptomatology increase with the number of attempts. Within the framework of selective and indicated prevention, it is essential to identify the group of patients with an increased risk of recurrence. The objective of this study is to identify factors predicting suicide attempt relapse to improve the decision making process in the therapeutic approach to suicidal behavior. The methodology employed was a longitudinal design aimed at identifying factors, in a binary logistic regression model (stepwise), predicting the repetition of suicidal behavior among a sample of 417 participants aged between 8 and 17 years old, at the six months follow-up. A statistically significant model χ2(3, N = 417) = 18.610; p < .001; Nagelkerke R 2 = .096 including the following factors was obtained: current diagnosis of personality disorder/maladaptive personality OR = .806, p = .028, 95% CI [1.091, 4.595], personal history of self-injury OR = .728, p = .043, 95% CI [1.023, 4.192], and family history of psychopathological diagnosis OR = .925, p = .021, 95% CI [1.151, 5.530]. Considering these results, having a diagnosis of personality disorder or maladaptive personality traits, presence or history of self-harm and family history of psychopathology draws a predictive profile of autolytic attempt recurrence during the six months after the initial intervention at the emergency room.

The Hidden Sufferers: Parental Reactions to Childhood Cancer during Treatment and at Survival.

This study was twofold: 1) to assess parental reactions to childhood cancer throughout the oncological experience and 2) to explore associations between parents' reactions during treatment and cancer-related distress at survival. A cross-sectional descriptive study collecting data (at survival) from retrospective (perceived social support, optimism, distress, coping in the worst situation) and current variables (general stress, distress regarding cancer, benefit finding) was carried out. Forty-one parents of childhood cancer survivors were assessed. High levels of distress (M = 9.5, SD = 1.32, range 4-10) and self-reported efforts to overcome difficulties occurring during the hospitalization (M = 7.48, SD = 3.01, range 0-10) were found. However, parents received high social support from very different sources. This could explain the satisfactory levels of optimism found (43.9% of the sample, M ≥ 16, range 9 - 24). Most parents reported to use engagement (M = 2.57, SD = 0.41, range 1-4) and help-seeking (M = 2.52, SD = 0.53, range 1-4) coping strategies to overcome difficulties. Some parents recognized to use psychological defenses when coping with the distress of cancer. However, this disengagement style was less preferred (M = 1.62, SD = 0.37, range 1-4). Finally, 22% of parents reported positive consequences and 60% reported positive and negative consequences too. When exploring how treatment experiences can influence cancer-related distress in survivorship, we observed that those who received less social support used more disengagement coping and referred higher efforts to overcome difficulties during treatment, displayed persistent distress at survival. These same parents showed higher scores on general stress. Besides, these results were not influenced by child's sequelae at survival. These findings support the hypothesis that "the end of treatment is not the end". Consequently, special attention should be placed in screening parents experiences throughout different milestones of cancer to design tailored interventions aimed at reducing persistent distress at survival.

Surviving cancer: The psychosocial outcomes of childhood cancer survivors and its correlates.

This study assessed the psychosocial outcomes of adolescent cancer survivors and their relationship with personal and socio-familiar factors. Using a cross-sectional design, 41 survivors answered the four psychosocial dimensions of the KIDSCREEN-52 questionnaire and measures for social support and coping. Similarly, 41 parents answered coping and cancer-related distress measures. All psychosocial scores were within normative values (50 ± 10). Multiple linear regression analyses revealed four models with a range of explained variance between 9.4 percent and 31.9 percent that include the informative and emotional support, parental distress, and coping. This study contributes to the understanding of psychosocial outcomes of childhood cancer survivors and its correlates.